Organization
CULLMAN PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE BLANKENSHIP (CREDENTIALING COORDINATOR)
(256) 739-0801
Entity
Organization
Contact information
Practice address
408 CLARK ST NE, CULLMAN, AL 35055
(256) 734-3202
(256) 734-4668
Mailing address
503 CLARK ST NE, CULLMAN, AL 35055-1921
(256) 739-0801
(256) 739-0027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529601950
—
AL
Enumeration date
06/23/2010
Last updated
06/15/2023
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